Sam/outreach Program

NPI #1003145665 in Lincolnton, North Carolina

Provider Information

NPI Number: 1003145665
Entity Type: Organization
Organization Name: Sam/outreach Program
Primary Specialty: Specialist
Enumeration Date: Dec 10, 2009
Last Updated: Dec 10, 2009

Practice Location

Address: 114 E MAIN ST
Address 2: STE. B
City: Lincolnton
State: North Carolina
ZIP Code: 28092-2725
Phone: (704) 740-6512

Authorized Official

Name: MRS. ROSALIND TERRELLE BYNUM
Title: EXECUTIVE DIRECTOR
Phone: (704) 740-6512

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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